SANAC’s ability to coordinate South Africa’s national HIV response is under parliamentary scrutiny, with the Select Committee on Social Services identifying concrete gaps in funding, legal authority and operational delivery across all three tiers of the country’s AIDS Council structure.
The committee’s briefing this week exposed a fragmented implementation landscape. During the fourth quarter of 2025/26, eight of South Africa’s Provincial Councils on AIDS met the functionality threshold. By the first quarter of 2026/27, three had deteriorated to semi-functional status. SANAC attributed the decline to political transitions, irregular meetings and resource constraints. District AIDS Councils performed better, with 39 of 46 structures classified as functional. Local AIDS Councils remain the weakest tier, hampered by insufficient staffing, funding and support.
The structural problem at the centre of the briefing is this: SANAC was established through a Cabinet decision, not parliamentary legislation. That absence of statutory authority limits the council’s ability to enforce compliance across sectors, secure dedicated funding streams and establish clear accountability mechanisms. Without legislative grounding, SANAC cannot compel coordination from provincial departments, municipalities or other government bodies. The council has requested parliamentary support for the National Multi-Sector Policy Framework, ring-fenced coordination funding and stronger political backing for AIDS Councils.
SANAC outlined its operational approach as a combination prevention model integrating biomedical, behavioural and structural interventions. The framework includes comprehensive sexuality education, integrated sexual and reproductive health services, advanced HIV prevention technologies, behaviour change campaigns and community engagement involving parents and caregivers. The council stated that its strategy aims to ensure no young person is left behind, including boys.
Meanwhile, committee members raised particular alarm about the defunding of community outreach programmes. Weakened prevention campaigns, they warned, leave vulnerable communities directly exposed to infection. Members highlighted the critical role of home-based care workers and called for attention to resource constraints and stipend-related challenges affecting frontline workers. The committee also sought clarity on SANAC’s collaboration with law enforcement agencies to address statutory rape and intergenerational relationships, which continue to drive teenage pregnancy and HIV infections among young women.
Members made clear that South Africa’s response cannot remain confined to the health sector when poverty, unemployment, gender-based violence and substance abuse continue to deepen community vulnerability. Effective HIV prevention, the committee stressed, requires a whole-of-society approach involving communities, families, traditional leaders, civil society, faith-based organisations, law enforcement and all spheres of government.
Committee Chairperson Desery Fienies framed the engagement as a foundation for action rather than a conclusion. “The committee appreciates the detailed and honest engagement from SANAC. Members have highlighted critical issues relating to adolescent HIV infections, teenage pregnancy, gender-based violence, poverty, substance abuse, youth-friendly healthcare services and the sustainability of community-based programmes. These challenges require coordinated action across all sectors of society if we are to protect vulnerable communities and reduce new HIV infections,” Fienies said.
The committee has requested that SANAC provide a comprehensive account of its resources, the extent of government financial support and its funding gaps, so Parliament can determine what intervention may be required to strengthen the country’s HIV, TB and STI response. Whether that intervention takes the form of legislation, ring-fenced budget allocations or both remains the open question now sitting before the committee.